Exercise to Treat Frailty in Kidney Transplant Candidates
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/26/2018 |
| Start Date: | April 12, 2018 |
| End Date: | April 10, 2019 |
Exercise as an Intervention to Treat Frailty and Decreased Physical Function in Kidney Transplant Candidates
Frailty is a condition characterized by slowness, weakness, low physical activity, wasting,
and exhaustion. Frailty increases the risk for adverse outcomes following transplant such as
increased length of stay in the hospital, mortality, or graft function. No interventions for
frailty are known for patients with renal disease, but exercise programs like pulmonary
rehabilitation have been effective in improving frailty in patients with other diseases, such
as lung disease. The goal of this study is to test whether exercise will also improve frailty
among patients who are waiting for a kidney transplant and who are considered frail or
pre-frail.
and exhaustion. Frailty increases the risk for adverse outcomes following transplant such as
increased length of stay in the hospital, mortality, or graft function. No interventions for
frailty are known for patients with renal disease, but exercise programs like pulmonary
rehabilitation have been effective in improving frailty in patients with other diseases, such
as lung disease. The goal of this study is to test whether exercise will also improve frailty
among patients who are waiting for a kidney transplant and who are considered frail or
pre-frail.
RECRUITMENT: This study will be conducted at Mayo Clinic in Rochester, MN. Patients over 18
who were approved for kidney transplant and identified as frail or pre-frail during their
kidney transplant evaluation will be approached for recruitment. Interested patients will go
through the informed consent process and, if frailty testing was not completed within the two
weeks prior to consent, patients will complete frailty testing. If patients are considered
frail or pre-frail, they will be enrolled in the study.
FRAILTY TESTING: Participants will complete the Short Physical Performance Battery (SPPB) and
other frailty testing at the beginning of the study, 4 weeks after beginning the
intervention, and 8 weeks after beginning the intervention. Frailty testing will include a
hand grip strength test, a gait speed test over 15 feet, repeated chair stands, balance
testing, and a body composition scan. Participants will also be asked to wear an activity
monitor for 5-7 days at each testing point and to complete a set of questionnaires.
INTERVENTION: Participants will be asked to complete 2 1-hour exercise sessions per week for
8 weeks (16 total sessions) under the supervision of a licensed respiratory therapist in
Rochester, MN on non-dialysis days. The exercise sessions will be based on pulmonary
rehabilitation and will follow guidelines established by the American Thoracic Society.
Exercise sessions will include endurance, strength, and flexibility training and will be
tailored to individual participants.
who were approved for kidney transplant and identified as frail or pre-frail during their
kidney transplant evaluation will be approached for recruitment. Interested patients will go
through the informed consent process and, if frailty testing was not completed within the two
weeks prior to consent, patients will complete frailty testing. If patients are considered
frail or pre-frail, they will be enrolled in the study.
FRAILTY TESTING: Participants will complete the Short Physical Performance Battery (SPPB) and
other frailty testing at the beginning of the study, 4 weeks after beginning the
intervention, and 8 weeks after beginning the intervention. Frailty testing will include a
hand grip strength test, a gait speed test over 15 feet, repeated chair stands, balance
testing, and a body composition scan. Participants will also be asked to wear an activity
monitor for 5-7 days at each testing point and to complete a set of questionnaires.
INTERVENTION: Participants will be asked to complete 2 1-hour exercise sessions per week for
8 weeks (16 total sessions) under the supervision of a licensed respiratory therapist in
Rochester, MN on non-dialysis days. The exercise sessions will be based on pulmonary
rehabilitation and will follow guidelines established by the American Thoracic Society.
Exercise sessions will include endurance, strength, and flexibility training and will be
tailored to individual participants.
Inclusion Criteria:
- Aged 18 or older
- Approved for kidney transplant at Mayo Clinic in Rochester, MN
- A Short Physical Performance Battery (SPPB) score ≤10 or considered frail or pre-frail
by Frailty Phenotype (FP)
Exclusion Criteria:
- Younger than 18 years
- Ineligible for kidney transplant
- Patient has not received cardiac clearance for transplant
- An SPPB score >10 or not considered frail or pre-frail by FP
- Non-English speaker without availability of adequate interpreter services (safety
concern)
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